The proposed study will test the effectiveness of a culturally-sensitive organ and tissue donation intervention for African American (AA) families and clergy of AA religious organizations. Group 1 will participate in formative research that seeks to understand the needs, knowledge, beliefs, attitudes, experiences, and vocabulary surrounding organ and tissue donation among family members and clergy. The remaining groups will participate in the intervention effectiveness trial. Group 2 (Comparison = C) will receive standard donation educational messages in the form of pamphlets and culturally-sensitive videotapes as well as education through the currently available outreach initiatives. Group 3 (Intervention = I) will receive the same intervention as Group 2 as well as: (a) culturally-sensitive written materials, (b) a family-oriented video that focuses on the donation process, and (c) an intervention educating the clergy of their religious organizations. The study will test two primary hypotheses: H1: Individuals receiving a culturally-sensitive family-oriented intervention (I) will show significantly greater increases in stage of readiness to discuss donation with family, stage of readiness for cadaveric donation, and stage of readiness for living donation than those who receive standard donation education (C). The primary goal of comparing groups C and I is to determine the efficacy of a culturally-sensitive family-oriented intervention developed using the """"""""deep structure"""""""" model of cultural sensitivity described in Resnicow, Baranowski, Ahluwalia, and Braithwaite (1999) and the utility of involving clergy. H2: The effect of the intervention will be mediated by increased use of the intervention materials (assessed at posttest); knowledge about the donation process; trust of the medical establishment; and variables from the Trans-theoretical Model and Theory of Reasoned Action (Fishbein, 1967) such as decisional balance for discussing donation with family, committing to donation, and for cross-cultural donation; perception of social norms related to discussion and donation; and self-efficacy for discussing donation with family members. Mediation will be tested through structural equation modeling.
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